ATI RN
RN ATI Maternal Newborn 2023 with NGN Questions
Extract:
Question 1 of 5
A nurse is teaching a client who has pregestational type 1 diabetes mellitus about management during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: C
Rationale: The correct answer is C because continuing to take insulin even during nausea and vomiting is crucial to prevent complications of hyperglycemia. Nausea and vomiting can lead to decreased food intake, risking hypoglycemia without insulin.
Choice A is incorrect as insulin needs may decrease in the first trimester.
Choice B is incorrect as moderate exercise is not recommended if blood glucose is 250 or greater.
Choice D is incorrect as a bedtime snack high in refined sugar can lead to unstable blood sugar levels.
Question 2 of 5
A nurse is caring for a client who is in labor and reports increasing rectal pressure. They are experiencing contractions 2 to 3 min apart, each lasting 80 to 90 seconds, and a vaginal examination reveals that their cervix is dilated to 9 cm. The nurse should identify that the client is in which of the following phases of labor?
Correct Answer: D
Rationale: The correct answer is D: Descent. At 9 cm dilation, the client is in the second stage of labor, which consists of the descent and birth of the baby. Increasing rectal pressure indicates the baby is descending into the birth canal. Contractions 2-3 min apart lasting 80-90 seconds are characteristic of the active phase of the second stage. Passive descent (choice
A) refers to the initial descent of the baby before the active pushing stage. Active (choice
B) and early (choice
C) phases are terms used for the first stage of labor, not the second stage. The client's dilation and symptoms clearly indicate they are in the descent phase of the second stage of labor.
Extract:
“A nurse is caring tor a newborn.
Exhibit1:
Medical History. Apgar score 9 at 1 min and 9 at 5 min Birth weight 4,706 g (10 lb 6 oz)| Gestational age
40 weeks Difficult vaginal birth with shoulder dystocia.
EXHIBIT2:
Nurses: Notes 1700: Newborn is active and moves all extremities except for right arm. No spontaneous
movement of the right arm noted, Right arm remains at side during Moro reflex.
Exhibit3:
Physical examination 1830: Absent Moro reflex noted in right arm. Right shoulder and arm are internally
rotated and adducted. Elbow extended. Forearm pronated with wrist and fingers flexed. Diagnosis.
brachial prexus injury resulting in trot Duchenne (Erb's palsy) paralysis
Question 3 of 5
Which of the following actions should the nurse plan to implement? For each potential nursing action, click to specify if the intervention is Indicated or contraindicated for the newborn
| Potential Nursing Action | Indicated | Contraindicated | |
|---|---|---|---|
| Educate the parents to begin range of motion exercises on the affected arm after 1 week. | |||
| Assess for grasp reflex in the affected extremity. | |||
| Immobilize the arm across the abdomen by pinning the newborn's sleeve to their shirt. | |||
| Instruct parents to limit physical handling for 2 weeks. |
Correct Answer: B
Rationale: [0, 1, 0, 0]
The correct answer is B: Assess for grasp reflex in the affected extremity. This is indicated to evaluate neurological function. Educating parents on range of motion exercises after 1 week, immobilizing the arm, and limiting physical handling are contraindicated as they can lead to complications and hinder recovery in a newborn with a possible neurological issue.
Extract:
Question 4 of 5
A nurse who is caring for a client who is at 15 weeks of gestation, is Rh-negative, and has just had an amniocentesis. Which of the following interventions is the nurse's priority following the procedure?
Correct Answer: C
Rationale: The correct answer is C: Administer Rh(0) Immune globulin. After an amniocentesis, there is a risk of Rh sensitization due to potential mixing of maternal and fetal blood. Administering Rh(0) Immune globulin helps prevent the mother from developing antibodies against Rh-positive blood cells of the fetus. This intervention is crucial to prevent hemolytic disease of the newborn in subsequent pregnancies. Checking the client's temperature (
A) is important, but not the priority immediately after amniocentesis. Observing for uterine contractions (
B) is important but not the priority in this scenario. Monitoring the fetal heart rate (
D) is also important but not the priority post-amniocentesis.
Question 5 of 5
A nurse is caring for a client who is at 10 weeks of gestation. Which of the following findings should the nurse report to the provider?
Correct Answer: A
Rationale: The correct answer is A because frequent vomiting with significant weight loss in a short period can indicate hyperemesis gravidarum, a severe form of morning sickness that can lead to dehydration and malnutrition, posing risks to both the mother and fetus. Weight loss of 3 lb in 1 week is concerning and requires immediate medical attention to prevent complications.
B: Reports of mood swings are common during pregnancy due to hormonal changes and are not typically a cause for immediate concern.
C: Nosebleeds occurring 3 times per week are often due to increased blood volume and hormonal changes during pregnancy and are usually not a serious issue unless severe or persistent.
D: Increased vaginal discharge is a common symptom during pregnancy due to hormonal changes and increased blood flow to the pelvic area, typically not a cause for immediate concern unless accompanied by other symptoms like itching or foul odor.